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1 IFIED PROGRAM CONSOLIDATUD FORM TANK: PR0234383 v� PR#: 0333 UNDERGROUND STORAGE TANKS -TANK PAGE 1 FAC#: FA0003670 I (two pages per tank) 7�7 OZ Paget of5 TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6TEMPORNRYSFJE CLOSURE Llxck van _.. ❑ 7 PERMANENTLY CLOSED ON SITE ( onN N (Sa=�6 w n for laal ise onlm (>pa�ry rwsen.to local m<onbr) ❑ STANK REMOVED 439 ❑ 3RENEWAL PERMIT o D BUSINESS NAME(Sameaa FACRITYNAMEor DBA-Doing B�o11 N) l FACIllTY ID: PR 4: ITT= LINDEN ASSOCIATED GROWERS FA00031 PR0234383 LOCATION WITHIN SITE(Opneoa0 14175 E HWY 26,LINDEN 4n PHONE 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be subrmtted to the local agency.) TANK ID# Tank#: 3 412 TANK MANUFACTURER ail COMPARTMEMALIZED TANK ❑Yes ❑No 434 TA0438303 UNKNOWN lvyw,cm,plen.mPag<fineauh mmpammnt DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 1,500 / REGULAR TWO ADDITIONAL DESCRPTION(Pmleul me muy) 438 3/13/00 CHNG PE FR 2325 TO 2360 PER TISH.LBR D.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 'W0 ® 1.MOTOR VEHICLE FUEL ® la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL nfmaek<dmmpbn<Purole.Typ<) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADEUNLEADED ❑ 4.GASOHOL ❑99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(Gum Ha aek.Matafala lmerael ag<) 441 CAS#(Rom Haaarmm Materials Immtoq page) 442 ❑ 4.HAZARDOUS WASTE (Lelada UaM0i1) ❑ 95.UNKNOWN M.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Checkerc aem only) EXTERIOR MEMBRANE LINER ❑95.UNKNOWN ® 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT 99.OTHER TANK MATERIAL-Primary tank ❑ I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 144 (Check one item only) ❑ 2.STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary rank ❑ 1.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (auk one it.miy) ❑2.STAINLESS STEEL F1 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑99.OTHER ❑ 5.CONCRETE 447 TANK INTERIOR LINING ❑ I.RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED OR COATING ❑ 99.OTHER (Cbakooeimwonby) ❑2ALKYD LINING ❑4PHENOLIC LINING ®6UNLINED (Fnebonlm<euly) 449 OTHER CORROSION ❑ I MANUFACTURING CATHODIC M 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED PROTECTION IF APPLICABLE PROTECTION ❑ 41MPRESSED CURRENT ❑ 99 OTHER (O"ol`.lwm MID ❑ 2 SACRIFICIAL ANODE (Falooimeony) SPILL AND OVERFI4L�L YEAR INSTALLE450 TYPE(lowlmeeny) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apply) J] I SPILL CONTAINMENT ❑ 1 ALARM ❑ 3 FILL TUBE SHUT OFF VAL' �+] 2 DROP TUBE g] 2 BALL ❑ 4 EXEMPT 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A damiption of da monito=ingprogmm shall be submined w the local ameaq 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 IF SINGLE WALL TANK(L'Iwck all Wt apply) (Check mm item oidy) ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSE ZONE ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 450 ❑Yes ❑ Na UPCF(12/99 revised)